Prostate Cancer Screening and Disease Management: How Screening May Have an Unintended Effect on Survival and Mortality—The Camel’s Nose Effect

Purpose

Evidence suggests that men diagnosed with prostate cancer live as long as or longer than those without a diagnosis. We postulate that a reason for this paradox is increased preventive and therapeutic health care interventions following a prostate cancer diagnosis. We explored this phenomenon in patients surgically treated for prostate cancer.

Materials and Methods

We examined the records of patients who underwent radical prostatectomy at Audie L. Murphy Veterans Hospital between 2001 and 2004, focusing on cancer related and comorbidity data including new diagnoses, interventions and medications.

Results

A total of 174 subjects had complete data for review. Of these men 72% had a change in medical regimen after diagnosis, 61% had a change in medication and 29% received a new medical diagnosis. Three men underwent cardiac catheterization and 1 had coronary bypass surgery.

Conclusions

These data highlight the extent of evaluation and subsequent changes in medical treatment regimens that occur after a diagnosis of prostate cancer. Such interventions would be expected to affect survival outcomes of men recently diagnosed with prostate cancer.

Key Words: prostatic neoplasms, drug screening assays, antitumor, prostate-specific antigen

Abbreviations and Acronyms: MUGA, multiple gated acquisition scan, PSA, prostate specific antigen, VA, Veterans Administration